The Status Quo Of Nurses’ Emotional Labor And Its Relationship With Work Engagement

Objectives1.To translate the scale of Emotional Labor for Nurses into Chinese,and evaluate the reliability and validity of the Chinese version of the Emotional Labor scale for Nurses;2.To investigate the current situation of nurses’emotional labor in Henan Province with the Chinese version of the Nurses’Emotional Labor Scale,and analyze the influencing factors;3.To analyze the relationship between nurses’emotional labor and their work engagement and try to build mathematical models between the two,so as to provide a basis for improving nurses’emotional labor and increasing their work engagement.MethodsThis research consists of two parts:the first part was the reliability and validity of the emotional labor scale for nurses,and the second part was the status quo of nurses’emotional labor and its relationship with work engagement.The first part was the reliability and validity of the emotional labor scale for nurses.After contacting the original author of the scale and obtaining authorization,the scale was translated into Chinese by means of sequential translation,back translation,cultural adjustment and pre-survey.The convenience sampling method was used to select 561 nurses from the third-level hospitals in Zhengzhou for a formal survey.Internal consistency reliability,test-retest reliability,half-reliability,content validity,standard validity and structural validity were used to evaluate the psychological measurement attributes of the scale.The second part was the investigation of the current situation of nurses’emotional labor.Using multi-stage stratified random sampling,528 nurses from 5 tertiary A general hospitals in Henan Province were selected as the research objects.The general information questionnaire,the Chinese version of the Emotional Labor Scale for nurses,and the Work Engagement Scale were used to investigate the current situation of nurses’emotional labor in Henan Province,analyze the relationship between emotional labor and work engagement,and try to build mathematical models between the two variables.Epidate software was used to enter the data,and SPSS 21.0 software was used to analyze the data.Statistical methods include descriptive analysis,Kruskal-Wallis test or Mann-Whitney U test,Spearman correlation analysis,and curve estimation.Curve estimation models include linear,quadratic,compound,growth,logarithmic,cubic,S,exponential distribution,inverse model,power and logistic models.According to the fitting determination coefficient R² of the fitted curve and the actual clinical significance,the most suitable fitting model was selected.ResultsThe results of the first part formed a nurses’emotional labor scale suitable for Chinese cultural background and nursing situation.The Chinese version of the emotional labor scale for nurses contains three dimensions:“emotional control effort in profession”（7 items）,“patient‐focused emotional suppression”（5 items）,“emotional pretense by norms”（4 items）.The Cronbach’sαcoefficient of the total scale was 0.862,and the Cronbach’sαcoefficient of each dimension was between 0.764 and 0.881.The test-retest reliability of the scale was 0.877,and the split-half reliability was 0.923.The content validity of the total scale was 0.969（>0.90）,and the content validity of each item was greater than 0.8.Exploratory factor analysis using principal component analysis with varimax rotation revealed a three-factor model,which accounted for61.281%of the total variance,and the factor loadings of all items were greater than0.40.Based on the structure and dimensions of the original scale,confirmatory factor analysis of the Chinese version scale was carried out,and the factor loadings were all greater than 0.4,fitting indexχ²/df=1.670,RMSEA=0.049,RMR=0.039,GFI=0.936,NFI=0.925,RFI=0.900,IFI=0.968,CFI=0.965,PCFI=0.726.The results of the second part showed that the average score of the nurse emotional labor scale was 3.94（3.63,4.19）,and the scores for each dimension were as follows:“emotional control effort in profession”（4.29）,“patient‐focused emotional suppression”（3.60）,“emotional pretense by norms”（3.50）.Among them,the highest item score was5.00 points,and the lowest score was 3.00 points.The results of Kruskal-Wallis test and Mann-Whitney U test showed that female nurses had significantly higher emotional labor scores than males（P<0.05）.Nurses with different professional titles only have differences in the scores of“emotional control effort in profession”（P<0.001）.There were no significant differences in the scores of various dimensions of emotional labor for different education levels and marital status.The Spearman correlation analysis showed that professional emotional regulation was positively correlated with the three dimensions of work engagement（vigor:r=0.634,P<0.001;dedication:r=0.664,P<0.001;absorption:r=0.616,P<0.001）.There was no significant correlation between“patient‐focused emotional suppression”and work engagement.“Emotional pretense by norms”was positively correlated with the three dimensions of work engagement（vigor:r=0.134,P<0.001;dedication:r=0.124,p<0.001;absorption:r=0.119,P<0.001）.Taking professional emotion regulation as the independent variable and work engagement as the dependent variable,regression analysis was used to estimate the curve.The results showed that the best fitting model was a quadratic model（R²=0.57,P<0.001）,and its mathematical model formula was:Y₁=0.078+0.572 X₁+0.082 X₁².Taking“patient‐focused emotional suppression”as the independent variable,work engagement as the dependent variable,the best fitting model was the quadratic model（R²=0.569,P<0.001）,and the mathematical model formula was:Y₂=-4.445+5.218 X₂-0.747 X₂².Taking“emotional pretense by norms”as independent variables,work engagement as the dependent variable,the best-fitting model was a cubic model（R²=0.238,P<0.001）,and its mathematical model formula was:Y₃=-1.266+2.401 X₃-0.074 X₃²-0.043 X₃³.Conclusion1.The Chinese version of the Emotional Labor Scale for Nurses has good reliability and validity and can be used to measure the emotional labor of nurses in China.2.The results of this study showed that the emotional labor of nurses in Henan Province was at a moderate level.It was reminded that nurses need to master the correct methods of emotional control to cope with negative emotions encountered at work.3.There was a curvilinear relationship between emotional labor and work engagement,which prompts nurses to improve their awareness of emotional labor,grasp appropriate emotional input,and maintain good emotional connections and boundaries with patients,thereby increasing their work engagement.